Clinical Program Highlights

CRITICAL CARE

The MICU service at UMMC has long provided an excellent educational experience in tertiary critical care for the P/CC fellows and Internal Medicine . The MICU team is a multidisciplinary team of intensivists, fellows, residents with extensive support from and interaction with pharmacy and nutrition services. University of Minnesota Critical Care program is an integrated medical-surgical-anesthesiology-Advanced Practice RN Critical Care Service providing 24-hour coverage at UMMC (as well as on-site care in two other M Health system hospitals and tele-ICU service to 3 outlying sites) Intensivists from the three academic Departments cover both the SICU and MICU services at night, allowing nighttime residents from either the Medicine or General Surgery residencies to interact with faculty intensivists trained in other critical care pathways. This cross-training experience is likely unique among U.S. IM residency and fellowship training programs.

There is a joint fellowship education curriculum between the medical and surgical critical care fellowships with joint monthly conferences. Faculty from the Critical Care program publish approximately 10 papers per year from clinical observations or trials performed at UMMC. PACCS faculty have recruited subjects for proteomic studies in ARDS; randomized trials in patient-controlled sedation and early sepsis management. These and other studies have been supported by R-01 (NHLBI), R-21 (NINR), P-50 (NIGMS) and University of Minnesota KL-2 grants. The three academic departments jointly fund three to five $12-15,000 seed grants yearly prioritizing support for junior faculty projects. About 1/3 of the PACCS fellows’ scholarly output is related to critical care research.

CYSTIC FIBROSIS

A message from the Director of the Adult Cystic Fibrosis Program, Dr. Jordan Dunitz

Jordan Dunitz, MD and Joanne Billings, MD, MPH have developed the University of Minnesota Adult Cystic Fibrosis (CF) Program into one of the top-ranked clinical programs in the country while enrolling hundreds of patients in clinical trials. The Minnesota Cystic Fibrosis Center care team has broad-based clinical and scientific expertise, meeting the challenge of successfully diagnosing, treating, teaching, and performing research to understand and control all of the potential complications of CF. With an intensive focus on preventive care, we have some of the best outcomes in the nation. The CF program is multidisciplinary. In addition to pulmonary CF experts, specialists experienced in CF care include otolaryngologists (ENT), gastroenterologists, hepatologists, endocrinologists, interventional radiologists and surgeons. The care team also includes nurse coordinators, respiratory therapists, dietitians, social workers and research coordinators as well as pharmacists, physical therapists, psychologists and genetic counselors. We care for close to 400 adults with CF ranging from late teens to early 70's and well as over 60 CF lung transplant patients and a number of CF liver transplant patients. Fellows rotate on the CF and Lung Transplant inpatient service during their first year and have opportunity for CF outpatient clinic experience during their second and third years. Our large population and broad experience will allow interested fellows to develop expertise in all aspects of CF care.

LUNG TRANSPLANT

The lung transplant program at the University of Minnesota is one of the most active and most experienced in the nation, averaging approximately 45 transplants per year; and having performed over 1,000 transplants over the history of the program. Fellows rotate on the CF/Lung Transplant inpatient transplant service during their first year and have opportunity for lung transplant outpatient clinic experience during their second and third years. The U of M transplant program transplants patients with many types of advanced lung disease including COPD, ILD, cystic fibrosis and pulmonary hypertension--allowing fellows to gain experience in pre- and post-transplant management of these patient groups. The transplant team is multidisciplinary, including providers from Pulmonary Medicine, Cardiovascular and Thoracic Surgery, Internal Medicine, Pharmacy, Nutrition, and Social Work. Fellows rotate on the CF/Lung Transplant inpatient transplant service during their first year and have opportunity for Lung Transplant outpatient clinic experience during their second and third years.

INTERSTITIAL LUNG DISEASE AND SARCOIDOSIS

The Interstitial Lung Disease Program at the University of Minnesota fosters a multidisciplinary approach to the diagnosis and treatment of interstitial lung disease. In addition to our 6 pulmonary providers our team includes providers from rheumatology, radiology and pathology. Our team also includes dedicated clinical nurse coordinators as well as administrative and research coordinators. We are a regional referral center for ILD, in 2019 we saw over 1800 total patients, over 200 new, in our ILD clinic. The Pulmonary Fibrosis Foundation has selected our clinic as a Pulmonary Fibrosis Care Center Network, one of only 40 in the nation. In addition our clinic is a site for numerous multi-center trials in ILD and we participate in national registries.

Our fellows get extensive exposure to ILD during their training. We have a weekly multidisciplinary conference, open to fellows, where we review new and ongoing cases. Because our clinical program is so large and we are a regional referral center fellows will get significant exposure to ILD while rotating on the inpatient pulmonary consult service and the ICU at the University of Minnesota Medical Center. Fellows also have the opportunity to rotate through the ILD clinic during their second and third years.

Within our ILD program we also have a multidisciplinary Sarcoidosis program that has been designated as a center of excellence, one of 60 in the US. Our program is centered in the pulmonary clinic but also includes faculty from Cardiology, Dermatology, Nephrology. Neurology, Ophthamology and Rheumatology. We are a regional referral center and have a large cohort of patients with complicated and multisystem disease. Fellows get exposure to these patients on the inpatient services and during their ILD clinic sub-specialty rotation.